SAGA — Doing things properly

I need to lose weight to bring down my blood pressure

Case history 3: Ann Payne

Ann, a retired newsagent, is 64 and lives in Derby. She is 5ft 2 ins and weighs 11st 10lbs. Says Ann: "I got down to 8 st 7lbs 20 years ago after being diagnosed with high blood pressure, but gradually the weight has crept back on.

"Even though I am taking various medication for my blood pressure, it is still sometimes too high so I would love to lose weight as I know it should help bring it down - but I just can't seem to move it. I even tried giving up eating apples as I know they are high in calories, but that didn't help.

"I don't think I eat a lot," says Ann. "My husband Terry eats the same diet and he is very slim - he eats to live. Our diet is probably quite boring. I admit I don't really like most fruit, especially soft fruit, or vegetables, but I don't snack between meals and don't take milk or sugar in my drinks, I never eat cream, and I don't add salt at the table.

"The diet below is what I eat most days - sometimes we will have bacon or oven chips or pasta but I don't fry food. Although I've given up golf, and no longer get the hour's walking a day I did when working, we try to exercise regularly - a half hour brisk walk most days.

The evidence</h1><h1 class="h1smlsect">Day One

Breakfast 7.30am

Two Weetabix and All Bran with whole milk and 1 tsp sugar

Black tea

10.30 am

Black coffee

Lunch 12.00

Sandwich of home-made white bread spread with Olivio filled with ham or Cheddar cheese

Black tea

2.00 pm

Glass orange juice

3.00 pm

Black tea

4.00 pm

One apple

Supper 6.00 pm

Lamb chops or stew or chicken breast

Boiled potatoes

Peas

2 or 3 glasses wine

9.00 pm

Black tea, 2 digestive biscuits

(Most days Ann's diet doesn't vary from this though she tries to eat fish once a week)

The Diet Detective reports

Ann carries a lot of her surplus fat around her middle - with a 34" waist. This 'apple shape' means she is at higher risk of heart problems and diabetes and, with this risk factor along with her hypertension, it IS important that she tries to lose a stone or so.

While Ann is right in saying she doesn't eat a huge amount of calories, she doesn't have the advantage of height - the taller you are, the more you can eat and maintain a reasonable weight. Also, most of us find it harder to lose weight as we get older and this is because, after 35, our metabolic rate slows down.

It has been worked out that for every five years we are over 35, we need to reduce calories by 50 a day. So at 65 you should eat 300 fewer daily calories than you did at 35.

Most of us don't achieve this and, with the tendency to take less exercise as we age, the result is weight gain without any question of being greedy!

As for what she actually eats, while Ann has some of the right ideas, she needs to pay more attention to helping lower her blood pressure through a healthy diet. Such a diet will also help her lose weight slowly without hunger. Her dislike of most fruit and veg means that she is missing out on the potassium they contain, which is an important factor in regulating blood pressure.

While she doesn't eat a huge amount of fat, a lot of what she does eat is saturated. She is going short of the healthier, essential fats found in oily fish, plant oils, nuts and seeds. She's also short of calcium (in dairy produce and leafy greens), zinc (in wholegrains, fish, nuts and seeds) and magnesium (in nuts, seeds and pulses).

Overall I'd rate her diet 5 out of 10.

</h1><li><p>Portions - Reading between the lines, I believe that you have been giving yourself larger portions than you really need. So when you dish up bread, cereal, stews, potatoes, and so on - put a little less on the plate at each meal. (See typical female portion sizes for weight control below. You don't need to weigh things for ever more but doing this a few times WILL help you get the picture.) You can make up for this by increasing the amount of veg and fruit that you serve.</p>

• <p>Fruit - Concentrate on the fruits you do like, or at least tolerate. Chop apples, pears or oranges on to your breakfast cereal to add vitamin C, fibre, potassium, anti-oxidants and filling power. (Apples, at only about 50 calories each, by the way, are a low-calorie food and ideal for snacking on.)</p>
• <p>Vegetables - It's very important that you try to eat more vegetables, research shows that vegetarians have a much lower incidence of hypertension than meat eaters. No need to give up meat of course but go easy. Add vegetables to your diet by chopping them small and cooking them in your stews and pasta sauces - this way you can reduce the meat content and save on saturated fat and total fat, and you will tolerate the veggies more easily. Try to have a salad or veggie soup instead of your sandwich at least a few times a week.</p>
• <p>Pulses - Add pulses such as baked beans, lentils and kidney beans to stews and sauces - these are high in protein, potassium and soluble fibre and low in fat; also they taste great. To prevent flatulence, mash them a little and chew thoroughly.</p>
• <p>Snacking - This is to be recommended provided you choose fruit (rather than fruit juice), or a small amount of fresh nuts, seeds, or dried fruit or an oatcake (rather than digestives).</p>
• <p>Fat - To help reduce saturated fat and calories buy extra lean ham and lower-fat cheeses such as Feta. Or grate your cheese before putting it in a sandwich - it goes much further. Strong tasting Parmesan or extra mature Cheddars are also a good idea as you eat less. Try to eat more fish sandwich fillings, e.g. tuna in water, or canned sardines in tomato sauce, and add chopped salad. Instead of lamb chops try lean lamb steaks or pork steaks, and when making stews always remove the visible fat from meat. Lamb is quite a fatty food - at this time of year think about wild duck, venison, pheasant or turkey for your stews.</p>
• <p>Frying - Frying isn't always bad - a stir-fry with shredded leafy greens, mangetout, diced chicken etc and some brown rice or wholewheat noodles is healthy.</p>
• <p>Salt - Some of the foods you are eating - ham, Cheddar, spreads - are high in hidden salt (sodium) and many breakfast cereals are very high. Try muesli which is not only low in salt but also high in dried fruits, nuts and seeds. Oat-based muesli is high in soluble fibre which may help beat abdominal fat. Weigh out a 50g portion and stick to that!</p>
• Alcohol - Try to limit yourself to one small glass of wine a night - research shows that any more than that is of no health benefit for women and as little as half a bottle of wine can raise blood pressure levels. High alcohol intake contributes to abdominal fat.

Conclusion

If you make some of these swaps you will be giving yourself a healthy low glycaemic Index diet which, research shows, can help beat abdominal obesity and overweight over time.

Typical portion sizes for female weight control:

* Bread 30g slice

* Muesli 50g

* Meat 100g

* Potatoes 150g

* Hard cheese 30g

* Pasta (cooked weight) 200g

* Bolognese sauce 2 tbs

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Information on this site is for interest only and is not a substitute for professional medical advice. You should consult your own doctor about any specific health concerns.

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